How the Rorschach Test Became the Most Famous Tool in Psychiatry

A revealing new book sheds light on Hermann Rorschach and his controversial and inexplicably effective test.

The Rorschach Test, conceived 100 years ago by a young psychiatrist at a Swiss asylum, continues to divide the scientific community and fascinate the public. From Hillary Clinton to Andy Warhol, Jay-Z to DC Comics and Ted Cruz, the Rorschach is ubiquitous and almost constantly misunderstood: The famously evocative inkblots have come to represent a hidden meaning, a reflective tool, a matter of perspective, or, in Warhol's case, an inversion.

With his new book, The Inkblots: Hermann Rorschach, His Iconic Test, and the Power of Seeing, writer and translator Damion Searls strives to take the ambiguity out of the Rorschach, both the test and its creator. In the first in-depth biography of Hermann Rorschach, Searls chronicles the life of the Swiss psychiatrist from his birth in Zurich to his untimely death at the age of 38, leaning heavily on previously untranslated letters, writings, and archives. Searls then follows the pop-culture appropriation and scientific debate that has surrounded his inkblot test in the century that's followed.

Even during Rorschach's lifetime, the inkblot test was viewed warily. Although it worked—he could perform blind readings based on inkblot answers that consistently matched with other psychiatrists' understandings of their patients—the Swiss psychiatrist didn't have a robust theory of why it worked. Freud had his id, ego, and superego; Carl Jung had his collective unconscious; Rorschach, a younger contemporary of the two, had ten ambiguous paintings—the images were actually painted, not spilled—that consistently uncovered hidden parts of the patient's mind.

Draft of Card III. Courtesy of the Archiv und Sammlung Hermann Rorschach, University Library of Bern

The creation story of the inkblots is part of the appeal and much of the problem—that Rorschach drew ten inkblots that seemed preternaturally effective emboldens the faction of the scientific community that view them like horoscopes. But Searls's book traces the development of Rorschach's psychological chops, as well as the artistic, literary, and philosophical influences that helped him make aesthetic choices (for example, creating horizontally symmetrical images makes it easier for humans to recognize familiar shapes).

Still, Searls found in Rorschach's own writing that the psychiatrist recognized the issue with his test having no theoretical underpinning. Because he died so young, he never had the chance to create an overarching theory of the visual mind—instead, his test was treated like a technique or tool. "You don't really care why it works, you just try and get the statistics solid so you can be sure that it works," Searls recently told me, over the phone. "And I think in America, that's been most of the history of it."

The inkblots have been treated as something like the psychological community's state secret.

Because the follow-up research has focused on bolstering Rorschach's specific inkblots through empirical evidence—adding a mathematical legitimacy to the visual test—the inkblots themselves have taken on a sacred status. It was strange, and somewhat miraculous, that Rorschach painted ten inkblots that happened to work as a window into the unconscious mind. But now, with a century of research focused on them, those specific images have become incredibly valuable. For that reason, the inkblots have been treated as something like the psychological community's state secret.

At least they were until 2009, when an ER doctor from Moose Jaw, Saskatchewan, posted all ten images on Wikipedia, creating a panic in the psychiatric world. If the average person could see the images and learn about the most common answers, the theory went, he or she could hack the test. By answering only standard responses—bats, animal hides, humans—people could fake sanity; they could also purposely fake psychosis.

A New York Times article from that year quotes a spokeswoman for the Rorschach test's publisher, who had threatened to sue Wikimedia for copyright infringement. "It is therefore unbelievably reckless and even cynical of Wikipedia," she said, "to on one hand point out the concerns and dangers voiced by recognized scientists and important professional associations and on the other hand—in the same article—publish the test material along with supposedly 'expected responses.'"

Dr. Dale Siperstein, a clinical psychologist who teaches the Rorschach test to students at the Wright Institute in Berkeley, California, remembers the uproar about the publication of the inkblots online. "And then, of course, the images started to show up on mugs and plates and clothing," she says. "The community was concerned, but it turns out that simply having been exposed to the inkblots does not compromise an assessment."

The information in Searls's book could be much more damaging than leaked images, but it has at least as good a chance of actually bolstering the Rorschach by adding rich detail to the test's creation story.

Even websites coaching correct responses are not catastrophic, according to Siperstein, though the availability of that information makes it important for an examiner to be on guard for people attempting to distort their answers and achieve a certain reading—either offering exclusively "popular responses" to obtain a job or feigning psychological disturbance to be deemed unfit to stand trial. Context matters and can inform the examiner's interpretation, so she coaches her students to ask themselves: "Why? What are the stakes? In a particular evaluation, what would be the motivation to do that?"

Impressively researched and richly detailed, The Inkblots breaks down the relevance of certain types of responses and the way the scoring of specific answers has changed over the years. Taken as a tool to beat the test, the information in Searls's book could be much more damaging than leaked images. "I've had my moments of wondering about that," he admitted, "but the latest research seems to show that exposure doesn't ruin it. Because it's not like a word association test, where your first flash gut reaction is what matters."

Despite these worries, the book has at least as good a chance of actually bolstering the Rorschach by adding rich detail to the test's creation story. By explaining the psychiatrist's influences and reasoning, and debunking popular myths, Searls makes it hard to justify viewing the inkblots as fake science. Furthermore, the book makes a compelling case for the biography as a worthwhile tool toward understanding output. As the editor of Rorschach's own 1921 book, Psychodiagnostics, wrote in the preface: "The method and the personality of its creator are inextricably interwoven."

Descended from a family of artists, Rorschach's artistic upbringing and visual mind helps explain his test. The young psychiatrist was obsessed with the way that other people saw the world, and created his inkblots to be able to finally know. As Searls explains, what makes Rorschach and his test such an outlier in the psychology world is that "alone among the pioneers of psychology, Rorschach was a visual person and created a visual psychology."

This aspect is what makes the test so alluring—Searls explains the blots as "not not art"—while also spectacularly confounding. The ten inkblot designs are delivered one by one to the patient on 9.5"-by-6.5" white cardboard cards. The images are ambiguous, and the examiner asks the intentionally open-ended questions: "What might this be?" or "What do you see?" The patient's responses can uncover anything from psychosis to suicidal tendencies to personality traits. Searls explains in the book that, for a time, it was thought of as an "X-ray of the soul."

In Inkblots, Searls avoids that kind of hyperbole, although he does admit that he views the test as somewhat magical. He opens his book with a story of a man applying for a position working with children who is given a psychological evaluation. The man passes several comprehensive tests only to fail the Rorschach, where his answers expose a deranged and troubling psyche. Later, his psychologist calls the examiner, astounded that she understood personality aspects it took two years of therapy to expose. Incredibly, the Rorschach scoring (accounting for everything from how the patient physically interacts with the cards to the questions he asks the examiner) remains too subtle and technical to trick.

The mystique of Rorschach's blots has somehow weathered a century of controversy and two decades of exposure. Though Searls's book could possibly draw a roadmap to beat the test, these inkblots continue to provide a window into a hidden place in our minds and collective imaginations. Even the way we misunderstand them, or overestimate their power, tells us about ourselves. With Searls's book, we finally see that like a bat, a moth, or an animal hide, the doctor and the inkblots themselves have always meant something more.